2015年骨科医院感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing nosocomial infection in orthopaedic department in 2015

目的分析我院送检样本中病原菌的分布及耐药情况,为院内感染的控制和临床合理用药提供参考。方法对2015年我院各骨科住院患者的送检标本进行常规培养分离,API系统鉴定菌株,药敏试验采用E-test法和K-B纸片法,采用WHONET5.6软件进行数据统计。结果 2015年我院共送检细菌培养样本2 746份,筛选分离出病原菌402株,阳性率为14.64%。细菌检出率前三位分别为金黄色葡萄球菌(19.4%)、大肠埃希菌(17.7%)、阴沟肠杆菌(12.4%)。耐甲氧西林金黄色葡萄球菌(MRSA)阳性率为30.8%,未发现万古霉素耐药菌株。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)的阳性率为54.9%。结论金黄色葡萄球菌、大肠埃希菌、阴沟肠杆菌在骨科医院分离率较高,耐药现象较为普遍,应动态监测院其流行和耐药状况,为临床合理使用抗生素提供可靠依据。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in inspection samples in our hospital, and so as to provide reference for the control of nosocomial infection and clinical rational use of antibiotics. Methods The pathogens from samples in our hospital in 2015 were cultured, isolated, and then identified by API system. Drug sensitive test was carried out by E-test and K-B paper method. The statistical analysis of data was performed with WHONET5.6. Results A total of 402 pathogens were isolated from 2 746 samples, and positive rate was14.64%. The bacteria detection rate of Staphylococcus aureus was the highest（19.4%）, followed by Escherichia coli（17.6%） and Enterobacter cloacae（12.4%）. The positive rate of methicillin resistant Staphylococcus aureus（MRSA） was30.7%, and vancomycin resistant strains were not found. The positive rate of extended spectrum beta-lactamases（ESBLs） was 54.9%. Conclusion The separation rate of Staphylococcus aureus, Escherichia coli, Enterobacter cloacae were higher in the orthopaedic department, and the resistance phenomenon is relatively common. The medical staff should dynamically monitor the prevalence and drug resistance status, in order to provide reliable basis for clinical rational use of antibiotics.